The New BRAIN Initiative to Prevent and Treat Brain Attack (aka Stroke)

6.6.13 | 12:00 pm

A couple of weeks ago, the American Heart Association and American Stroke Association (AHA/ASA) hosted a briefing on Capitol Hill: “The BRAIN (Brain Research Through Advancing Innovative Neurotechnologies) Initiative: What is it and What Does It Mean for Stroke and Other Neurological Conditions?” The event was moderated by Sue Nelson, Vice President of Federal Advocacy, AHA/ASA, and additional speakers included: Bruce Ovbiagele, MD, Chair, Department of Neurology, Medical University of South Carolina; Kathy Hudson, PhD, Deputy Director for Science, Outreach and Policy, NIH; Story Landis, PhD, Director, NIH National Institute of Neurological Disorders and Stroke (NINDES); and Jose Maldonado, stroke survivor.

In a policy statement released at the briefing, the AHA/ASA predicts the cost of stroke may double by 2030 largely due to the aging U.S. population. Additionally, they forecast that by 2030:

  • Almost four percent of U.S. adults — nearly one in 25 — will have a stroke. This translates into an additional 3.4 million people with stroke in 2030.
  • Costs to treat stroke may increase from $71.55 billion in 2010 to $183.13 billion.
  • Annual costs due to lost productivity could rise from $33.65 billion to $56.54 billion.
  • Americans currently 45-64 years old are expected to have the highest increase in stroke at 5.1 percent.
  • Stroke prevalence is projected to increase the most among Hispanic men between now and 2030, and the cost of treating stroke in Hispanic women is expected to triple.

Drs. Landis and Hudson also provided an update on current research that is being funded by the BRAIN Initiative. The BRAIN Initiative has provided $110 million in funding to public institutions (NIH, National Science Foundation, etc.) and $122 million to private institutions. The project will require the development of new technologies that allow researchers to map the interaction of brain circuits. Those involved hope it helps treat complicated diseases, like Alzheimer’s, or tackle debilitating injuries, such as post-traumatic brain syndrome.

While it remains to be seen what the BRAIN project will discover, it certainly appears to be a step in the right direction. And, until those discoveries occur, the AANS, CNS and AANS/CNS Joint Cerebrovascular Section will continue to be dedicated to reducing the occurrence, disabilities and death associated with stroke by supporting continued research, clinical advancements and public awareness and education so we can help ensure that elected officials have a better understanding of how changes in healthcare and other public policies related to stroke prevention and treatment.

Posted in Congress, Emergency Care, Health, Healthcare Costs, Medical Innovation, Medical Research | Tagged , , , , , , , , , , , , , |

House Committee Unveils Framework to Replace the SGR

6.3.13 | 10:30 am

Last week, the talk of the town (amongst healthcare stakeholders) was about the House Energy and Commerce Committee’s draft legislative proposal for repealing Medicare’s sustainable growth rate (SGR) formula. While this skeleton discussion draft bill is very preliminary, it provides a legislative outline for replacing the current Medicare payment system with an “improved fee for service system in which providers – working with the Secretary of Health and Human Services – develop quality measures that will lead to better care in a more efficient manner.” According to the committee, the new system will be implemented in three phases as follows:

  • Phase 1: Repeal the SGR and replace it with a period of stable payments, during which time the quality infrastructure ramps up. Quality measures will be based on core competencies for each peer cohort (e.g., neurosurgeons) and will be developed by medical specialty societies and others.
  • Phase 2: The new Competency Update Incentive Program is implemented. Under this system, physicians would be paid a “base” rate per service, which would be some percentage of the full fee-schedule rate. To earn the full fee-schedule rate, physicians must successfully meet the peer cohort quality program requirements. Physicians can opt out of this enhanced fee-for-service program, and instead participate in alternative payment models, such as accountable care organizations (ACOs).
  • Phase 3: At some point in the future, physician payments may also be based in part on compliance with efficiency measures.

Many questions remain. For example, while the legislation calls for the Secretary of Health and Human Services to align this program with the existing Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) and Value Based Payment Modifier (VBPM) programs, it is not clear whether existing PQRS, EHR and VBPM program penalties will remain in force on top of this new SGR quality payment withhold (we certainly hope not). The committee has scheduled a hearing on the draft legislation for June 5 at 10AM EST (watch it live here). In April, the AANS and CNS joined with the Alliance of Specialty Medicine in submitting comments on the original framework.

Posted in Coding and Reimbursement, Congress, Health, Health Reform, HIT, Medicare, Quality Improvement, SGR | Tagged , , , , , , , , , |

AANS Spotlight: Negotiating the Neurosurgical Learning Curve

5.30.13 | 10:50 am

The AANS Neurosurgeon is official socioeconomic publication of the American Association of Neurological Surgeons (AANS) which features information and analysis for contemporary neurosurgical practice. It focuses on issues related to legislation, workforce and practice management as they affect the specialty of neurosurgery. For today’s post we wanted to bring your attention to the newly released issue.

The concept of a sizable learning curve is familiar to any physician — from a resident just starting out to a seasoned surgeon with 25 years of experience —  practicing in the field of neurosurgery.  The May 2013 issue of AANS Neurosurgeon, “Negotiating the Neurosurgical Learning Curve,” examines how neurosurgeons gain expertise and ascend that very necessary slope. In fact, this issue presents an array of articles that provide different perspectives as to how neurosurgeons manage not one, but all the learning curves they inevitably encounter throughout their careers.

For example, in the feature article, “Adopting New Techniques in Private-practice Neurosurgery,” Mark Spatola, MD, FAANS, shares his personal experience integrating approaches that were not a part of his training into his neurosurgical routine. He discusses how he assimilated new techniques, as well as evaluated them once they were put into practice, and offers some suggestions on how other neurosurgeons might do the same. Dr. Spatola also addresses the introspective considerations that are important early in the process, such as acknowledging personal skill sets and recognizing the needs of the local community, before adopting new techniques.

Elsewhere in the issue, readers can check out new peer-reviewed research, book reviews, and updates from the DC office via its “Washington Watch” column. And as always, the “Neuros in the News” section features neurosurgeons and institutions on the move, from recent appointments to expanding departments and new neurosurgical centers.

Posted in AANS Spotlight, Health, Patient Safety, Quality Improvement | Tagged , , , , , |